title: Comparison of the anesthetic efficacy of the conventional inferior alveolar, Gow-Gates, and Vazirani-Akinosi techniques.
abstract: The purpose of this prospective, randomized study was to compare the degree of pulpal anesthesia obtained with the conventional inferior alveolar, the Gow-Gates, and the Vazirani-Akinosi techniques in vital, asymptomatic teeth. With a crossover design, 40 subjects received all 3 techniques in a random manner by using 3.6 mL of 2% lidocaine with 1:100,000 epinephrine at 3 separate appointments. An electric pulp tester was used to test for anesthesia in 3-minute cycles for 60 minutes of the first molars, first premolars, and lateral incisors. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes, and the 80 reading was continuously sustained through the 60th minute. The ranges of successful anesthesia were as follows: inferior alveolar technique, 25%-62%; Gow-Gates technique, 16%-44%; and for the Vazirani-Akinosi technique, 13%-50%. There was no significant difference (P > .05) in success among the 3 techniques. However, the Gow-Gates and Vazirani-Akinosi techniques resulted in a statistically slower onset of pulpal anesthesia than the inferior alveolar nerve block. We concluded that in vital, asymptomatic teeth and for the subjects who achieved lip numbness, the conventional inferior alveolar nerve block is similar to the Gow-Gates and Vazirani-Akinosi techniques regarding anesthetic success but has a faster onset of pulpal anesthesia.
authors.affiliation: Deceased.
authors.forename: Steven
authors.initials: S
authors.lastname: Goldberg
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio. Electronic address: reader.2@osu.edu.
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.affiliation: Department of Oral Biology, The Ohio State University, Columbus, Ohio.
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D018592:Cross-Over Studies; D003791:Dental Pulp Test; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008340:Mandibular Nerve; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine